Diverticular disease of the colon is a common disease worldwide.Although the disease is asymptomatic in about 70-80 % of patients,it represents,at least in Western countries,one of the most important gastrointestinal ...Diverticular disease of the colon is a common disease worldwide.Although the disease is asymptomatic in about 70-80 % of patients,it represents,at least in Western countries,one of the most important gastrointestinal diseases in terms of direct and indirect health costs.Pathogenesis of the disease is still unknown.However,it is the result of complex interactions between colonic structure,intestinal motility,diet and genetic factors.Whilst efficacious preventive strategies remain to be identified,fibre supplementation in the diet is recommended.Why symptoms develop is still unclear.Results of recent experimental studies on irritable bowel syndrome speculated that low grade inflammation of colonic mucosa,induced by changes in bacterial microflora, could affect the enteric nervous system,which is crucial for normal gut function,thus favouring symptom development. This hypothesis could be extrapolated also for diverticular disease,since bacterial overgrowth is present,at least in a subgroup of patients.These perspectives on symptom development are reviewed and new therapeutic approaches are hypothesized.展开更多
AIM： To investigate the change of bone parameters in a new model of experimentally induced liver cirrhosis and hepatocellular carcinoma （HCC） in growing rats. METHODS： Fischer-344 rats （n = 55） were used. Carbon...AIM： To investigate the change of bone parameters in a new model of experimentally induced liver cirrhosis and hepatocellular carcinoma （HCC） in growing rats. METHODS： Fischer-344 rats （n = 55） were used. Carbon tetrachloride （CCh）, phenobarbital （PB）, and a single diethylnitrosamine （DEN） injection were used. Animals were killed at wk 8 and 16. Bone mineral content, femoral length, cortical index （quotient of cortical thickness and whole diameter） and ultimate bending load （Fmax） of the femora were determined. The results in animals treated with DEN＋PB＋CCh （DPC, n = 21） were com- pared to those in untreated animals （UNT, n = 14） and in control group treated only with DEN＋PB （DP, n = 20）. RESULTS： Fatty liver and cirrhosis developed in each DPC-treated rat at wk 8 and HCC was presented at wk 16. No skeletal changes were found in this group at wk 8, but each parameter was lower （P〈0.05 for each） at wk 16 in comparison to the control group. Neither fatty liver nor cirrhosis was observed in DP-treated animals at any time point. Femoral length and Fmax values were higher （P〈0.05 for both） in DP-treated animals at wk 8 compared to the UNT controls. However, no difference was found at wk 16. CONCLUSION： Experimental liver cirrhosis and HCC are accompanied with inhibited skeletal growth, reduced bone mass, and decreased mechanical resistance in growing rats. Our results are in concordance withthe data of other studies using different animal models. A novel finding is the transiently accelerated skeletal growth and bone strength after a 8-wk long phenobarbital treatment following diethylnitrosamine injection.展开更多
Crohn’s disease is a chronic inflammatory granulomatous process that usually involves different sites in the intestinal tract. Genetic and environmental factors are thought to play a role in its etiology and pathogen...Crohn’s disease is a chronic inflammatory granulomatous process that usually involves different sites in the intestinal tract. Genetic and environmental factors are thought to play a role in its etiology and pathogenesis. The disorder has a heterogeneous clinical expression and data from tertiary care settings have documented its female predominance, occasional familial nature, and high rate of stricture formation and penetrating disease. It may appear from early childhood to late adulthood, although over 80% are currently diagnosed before age 40 years, usually with terminal ileal and colonic involvement. Several studies have now shown differences in phenotypic clinical expression depending on the initial age at diagnosis, with pediatric-onset disease being more severe and more extensive with more involvement of the upper gastrointestinal tract compared to adult-onset disease. In addition, long- term studies from these tertiary care settings have documented that the disorder may evolve with time into a more complex disease with stricture formation and penetrating disease complications (i.e. fistula and abscess). Although prolonged remission with no evidence of inflammatory disease may occur, discrete periods of symptomatic and active granulomatous inflammatory disease may re-appear over many decades. Long-term studies on the natural history have also suggested that discrete events (or agents) may precipitate this granulomatous inflammatory process.展开更多
文摘Diverticular disease of the colon is a common disease worldwide.Although the disease is asymptomatic in about 70-80 % of patients,it represents,at least in Western countries,one of the most important gastrointestinal diseases in terms of direct and indirect health costs.Pathogenesis of the disease is still unknown.However,it is the result of complex interactions between colonic structure,intestinal motility,diet and genetic factors.Whilst efficacious preventive strategies remain to be identified,fibre supplementation in the diet is recommended.Why symptoms develop is still unclear.Results of recent experimental studies on irritable bowel syndrome speculated that low grade inflammation of colonic mucosa,induced by changes in bacterial microflora, could affect the enteric nervous system,which is crucial for normal gut function,thus favouring symptom development. This hypothesis could be extrapolated also for diverticular disease,since bacterial overgrowth is present,at least in a subgroup of patients.These perspectives on symptom development are reviewed and new therapeutic approaches are hypothesized.
基金Supported by The Medical Research Council of Hungary, ETT 226/2003, 232/2003The Hungarian Scientific Research Fund, OTKA T038067, T038154
文摘AIM： To investigate the change of bone parameters in a new model of experimentally induced liver cirrhosis and hepatocellular carcinoma （HCC） in growing rats. METHODS： Fischer-344 rats （n = 55） were used. Carbon tetrachloride （CCh）, phenobarbital （PB）, and a single diethylnitrosamine （DEN） injection were used. Animals were killed at wk 8 and 16. Bone mineral content, femoral length, cortical index （quotient of cortical thickness and whole diameter） and ultimate bending load （Fmax） of the femora were determined. The results in animals treated with DEN＋PB＋CCh （DPC, n = 21） were com- pared to those in untreated animals （UNT, n = 14） and in control group treated only with DEN＋PB （DP, n = 20）. RESULTS： Fatty liver and cirrhosis developed in each DPC-treated rat at wk 8 and HCC was presented at wk 16. No skeletal changes were found in this group at wk 8, but each parameter was lower （P〈0.05 for each） at wk 16 in comparison to the control group. Neither fatty liver nor cirrhosis was observed in DP-treated animals at any time point. Femoral length and Fmax values were higher （P〈0.05 for both） in DP-treated animals at wk 8 compared to the UNT controls. However, no difference was found at wk 16. CONCLUSION： Experimental liver cirrhosis and HCC are accompanied with inhibited skeletal growth, reduced bone mass, and decreased mechanical resistance in growing rats. Our results are in concordance withthe data of other studies using different animal models. A novel finding is the transiently accelerated skeletal growth and bone strength after a 8-wk long phenobarbital treatment following diethylnitrosamine injection.
文摘Crohn’s disease is a chronic inflammatory granulomatous process that usually involves different sites in the intestinal tract. Genetic and environmental factors are thought to play a role in its etiology and pathogenesis. The disorder has a heterogeneous clinical expression and data from tertiary care settings have documented its female predominance, occasional familial nature, and high rate of stricture formation and penetrating disease. It may appear from early childhood to late adulthood, although over 80% are currently diagnosed before age 40 years, usually with terminal ileal and colonic involvement. Several studies have now shown differences in phenotypic clinical expression depending on the initial age at diagnosis, with pediatric-onset disease being more severe and more extensive with more involvement of the upper gastrointestinal tract compared to adult-onset disease. In addition, long- term studies from these tertiary care settings have documented that the disorder may evolve with time into a more complex disease with stricture formation and penetrating disease complications (i.e. fistula and abscess). Although prolonged remission with no evidence of inflammatory disease may occur, discrete periods of symptomatic and active granulomatous inflammatory disease may re-appear over many decades. Long-term studies on the natural history have also suggested that discrete events (or agents) may precipitate this granulomatous inflammatory process.
